Mesohepatectomy as an Option for the Treatment of Central Liver Tumors

Mehrabi, Arianeb; Mood, Zhoobin A.; Roshanaei, Navid; Fonouni, Hamidreza; Müller, Sascha; Schmied, Bruno M.; Hinz, Ulf; Weitz, Jürgen; Büchler, Markus W.; Schmidt, Jan

doi:10.1016/j.jamcollsurg.2008.05.024

Cited by 54 publications

(62 citation statements)

References 47 publications

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“…Seven studies reported disease-free survival [7,8,17,23,33,34,36] . The median Disease-free survival (DFS) in Hu et al [23] was 23 mo for HCC.…”

Section: Disease-free Survivalmentioning

confidence: 99%

“…The current literature directly comparing patients undergoing extended hemi-hepatectomy and CH is lacking [9,15,17,23,25] . There is only one study in the current literature with more than 100 patients (Table 1) [3,[7][8][9][17][18][19][20]22,23,25,[27][28][29][30][31][32][33][34][35][36][37] . The aim of this review is to analyze and compare the perioperative, early and long-term results of patients with centrally located liver malignancies, between those treated with CH and those treated with hemi-/extended hepatectomy.…”

Section: Introductionmentioning

confidence: 99%

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Central hepatectomy for centrally located malignant liver tumors: A systematic review

Lee¹

2014

WJH

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AIM:To study whether central hepatectomy (CH) can achieve similar overall patient survival and disease-free survival rates as conventional major hepatectomies or not. METHODS:A systematic literature search was performed in MEDLINE for articles published from January 1983 to June 2013 to evaluate the evidence for and against CH in the management of central hepatic malignancies and to compare the perioperative variables and outcomes of CH to lobar/extended hemihepatectomy. RESULTS:A total of 895 patients were included from 21 relevant studies. Most of these patients who underwent CH were a sub-cohort of larger liver resection studies. Only 4 studies directly compared Central vs hemi-/extended hepatectomies. The range of operative time for CH was reported to be 115 to 627 min and Pringle's maneuver was used for vascular control in the majority of studies. The mean intraoperative blood loss during CH ranged from 380 to 2450 mL. The reported morbidity rates ranged from 5.1% to 61.1%, the most common surgical complication was bile leakage and the most common cause of mortality was liver failure. Mortality ranged from 0.0% to 7.1% with an overall mortality of 2.3% following CH. The 1-year overall survival (OS) for patients underwent CH for hepatocellular carcinoma ranged from 67% to 94%; with the 3-year and 5-year OS having a reported range of 44% to 66.8%, and 31.7% to 66.8% respectively. CONCLUSION:Based on current literature, CH is a promising option for anatomical parenchymal-preserving procedure in patients with centrally located liver malignancies; it appears to be safe and comparable in both perioperative, early and long term outcomes when compared to patients undergoing hemi-/extended hepatectomy. More prospective studies are awaited to further define its role.

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“…Seven studies reported disease-free survival [7,8,17,23,33,34,36] . The median Disease-free survival (DFS) in Hu et al [23] was 23 mo for HCC.…”

Section: Disease-free Survivalmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Central hepatectomy for centrally located malignant liver tumors: A systematic review

Lee¹

2014

WJH

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“…5,6 Improvements in the understanding of liver anatomy and advancements in image technology have contributed to the development of segmental liver resection. 7 The ICGR 15 is useful for predicting the safe limit of liver resection in each patient, and liver volumetry using computed tomography is helpful for evaluating whether the [8][9][10] Preserving more liver parenchyma decreases morbidity and mortality rates 11 and increases the possibility of the second hepatic resection in the case of a recurrent intrahepatic tumor. 12 However, more extensive dissection of vascular pedicles and larger resection surfaces of liver parenchyma in CBS may result in excessive blood loss, longer duration of operation, or greater incidence of postoperative bile leakage, 8,13,14 and CBS has not been frequently used for treatment of centrally located liver tumors.…”

Section: Discussionmentioning

confidence: 99%

Central Bisegmentectomy for Malignant Liver Tumors: Experience in 8 Patients

Shiba

Haruki

Futagawa

et al. 2014

International Surgery

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Central bisegmentectomy (CBS) of the liver is an en bloc hepatic resection of Couiaud segments 4, 5, and 8. The indications for CBS include benign and malignant tumors occupying both the left medial and right anterior segments. However, CBS has rarely been reported. Here, we investigate CBS in patients with suboptimal liver function for whom an extended lobectomy is not an optimal solution. Each case was 1 of 8 patients who underwent CBS for hepatocellular carcinoma (HCC) or colorectal cancer liver metastasis (CRLM) at the Department of Surgery, Jikei University Hospital. Indications for CBS consisted of CRLM in 3 patients and HCC in 5 patients. The median duration of operation was 552 minutes, and median blood loss was 2263 g. No postoperative nor inhospital mortalities occurred. In this study, 1-, 2-, and 3-year disease-free survival rates were 62.5%, 12.5%, and 12.5%, respectively, and 1-, 2-, and 3-year overall survival rates were 100%, 100%, and 85.7%, respectively. CBS is advocated for central liver tumors in patients with suboptimal liver function for whom extended lobectomy could result in less than optimal remnant liver volume and function.

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“…This concept of applied embryology and anatomy was introduced to various organs to increase rate of negative margins of resection. Mesopancreas, mesogastrium, mesoesophagus, mesohepatectomy and mesometria were described based on postulates in analogy with mesorectum [13][14][15][16][17]. Whether these descriptions and further refinement in surgical technique based on these postulates will give better results or not is not yet known.…”

Section: Introductionmentioning

confidence: 99%

Mesopancreas in Pancreatic Cancer: Where do We Stand – Review of Literature

Ramachandra

Challa

2014

Indian J Surg Oncol

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Pancreatic cancer is associated with poor prognosis and surgery remains the main modality of treatment. Negative resection margin is an important prognostic factor for survival. Retropancreatic margin or the medial margin is the most common site of positive resection margin. Mesopancreas was proposed in analogy with mesorectum, which is considered as a fusion fascia formed embryologically during the development of pancreas. This mesopancreas lies posterior to the pancreas and contains pancreaticoduodenal vessels, lymphatics, nerve plexus and loose areolar tissue. Various technical modifications were proposed for better dissection of mesopancreas like posterior approach and artery first approach. There is an increased rate of R0 resection by these technical modifications but whether this will turn to increase in survival rates is yet to be established.

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Mesohepatectomy as an Option for the Treatment of Central Liver Tumors

Cited by 54 publications

References 47 publications

Central hepatectomy for centrally located malignant liver tumors: A systematic review

Central hepatectomy for centrally located malignant liver tumors: A systematic review

Central Bisegmentectomy for Malignant Liver Tumors: Experience in 8 Patients

Mesopancreas in Pancreatic Cancer: Where do We Stand – Review of Literature

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